Abstract
Recent progress in endoscopic resection (ER) has led to earlier identification and radical treatment of many colorectal cancers. However, laparotomy should be done for patients in whom sm invasion was detected after ER, owing to the possibility of lymph node metastasis.
Studied were patients with sm carcinoma who underwent second surgical operation following ER.
1. In terms of tumor size and macroscopic type, type IIa+IIc or type I carcinomas with longer diameters of 20mm or more were associated with lymphatic metastasis in a high rate. Thus, ER is not good for patients with such sm carcinoma.
2. Sm carcinomas were divided into 3 subdivisions, sml, 2 and 3. No lymph node metastasis was found in patients with sml carcinoma. However, metastasis was discovered in 16-17% of the patients with sm2 or 3 carcinoma.
3. The positive lymphatic metastatic rate was 10, 3% in patients who underwent second surgical operation.
4. Removal of invasive carcinoma of sm2 or more, along with scars, within 1 month after ER led to low lymphatic metastatic rates.
5. Requirements for radical treatment by ER include carcinoma with a longer diameter of 20mm or less, no infiltration to the margins of the resected lesion, well-differentiated adenocarcinoma, and invasion of sml or less.
